Extracorporeal shock wave lithotripsy (ESWL): alternatives and adjuvant procedures

Within a short time, extensive statistics on ESWL have documented its efficiency in the treatment of most renal and ureteral stones. Approximately 20% of all stone patients, however, require additional or other forms of therapy, such as URS, PNL, or surgery. Up to now, the differential indications for these procedures have not been completely established. A crucial factor for successful application of ESWL is stone volume and localization. Large stones with a central stone mass may be successfully treated by combining ESWL and PNL, while surgery is still preferred in those with a peripheral stone mass.